PEORIA — The big hospital news has been about big mergers recently — UnityPoint Health-Methodist affiliating with the former Proctor Hospital, OSF Healthcare steadily adding rural hospitals to its roster.

Another smaller, but no less significant merger has been in the works for four years. Heartland Community Health Clinic will officially take over Sisters' Community Health Care Center of OSF Saint Francis Medical Center Monday, solidifying its place as a major primary care provider for the uninsured, under-insured, and people in the state's Medicaid program.

Heartland's patient load will jump 40 percent, from 12,500 to 21,100, with the addition of its fifth clinical site and 8,600 primary care patients from Sisters' clinic.

Roughly one in nine Peoria County residents will now be served by Heartland. (Though Peoria County residents make up the bulk of Heartland's patients, the agency doesn't turn anyone away.)

The merger is a three-way collaboration between St. Francis, Heartland and the University of Illinois College of Medicine at Peoria, which trains young doctors in four residency programs at the clinic.

"For the patients, it will be seamless," said Sue Wozniak, the retired chief operating officer of St. Francis who served as project manager on the merger.

Patients will see the same supervised residents from the University of Illinois College of Medicine at Peoria whom they saw as patients of Sisters' clinic. They'll see the same nurses and the same staff. They'll go to the same location in the old Allied Agencies building along Armstrong Street. But the name will change to Heartland-Armstrong.

For Heartland, the acquisition means more resources to serve uninsured and, potentially, growing numbers of under-insured residents as key aspects of national healthcare reforms take hold, said Farrell Davies, Heartland's CEO.

More resources include a two-year federal grant, totaling $1.3 million, to help offset costs of the merger and provide care for more uninsured patients; new administrative offices in the recently-purchased old Wyman Building along University Street; and plans to hire 11 new employees, primarily in billing and information technology.

St. Francis is letting go of a clinic that, according to Wozniak, loses several million dollars a year. On the other hand, because of Heartland's designation as a federally-qualified health center, Heartland's Medicaid reimbursement rate is about $125 while Sisters' clinic is about $30 per patient visit.

Heartland's Davies cautioned the comparison is not apples-to-apples. Heartland is required to provide more services with the higher payment it receives, while the clinic could receive more for treating medically-complex patients.

"But from the perspective of the community and the healthcare system, it's more effective and efficient to have us provide the services."

The shift also ends costly duplication of services between Sisters' clinic and Heartland. For example, because parents could choose between Heartland and the Sisters' clinic, the clinic was in jeopardy of not having enough young patients for pediatric residents to treat.

"I want to make it very clear the Sisters are not abandoning their charity mission," Wozniak said.

St. Francis will retain the clinic's academic education component and approximately 400 patients in a separate clinic — St. Francis Community Clinic, a free clinic originally started in the 1940s for the poor and women who lost husbands in World War II. The hospital will pay Heartland for their care.

St. Francis is also taking steps to assure Heartland isn't hurt economically by the merger, a requirement for approval by the Health Resources and Services Administration, the federal agency that oversees medical care for under-served communities.

St. Francis will pay Heartland's up-front costs for the transition and increase its annual community benefits grant to Heartland from $500,000 to $1.5 million.

Wozniak said it's in St. Francis' best interests to make sure Heartland is successful.

"Every time they spend a dollar on the same thing we spend a dollar on, that's a dollar wasted."

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While hospital systems have been increasingly acquiring other hospitals, Heartland Community Health Clinic has been increasingly acquiring other hospitals' community clinics.

Heartland started in 1991 as a small free clinic on the near north side, staffed by volunteers. The goal was to provide basic medical services to the uninsured working poor. Two other small clinics, a primary-care clinic operated by the former Methodist Medical Center and a clinic at Human Service Center, had rolled into Heartland before its first decade.

In 2004, Heartland won federally-qualified health clinic, or FQHC, designation, allowing it to expand services.

By 2006, OSF Saint Francis Medical Center's Mother Frances Krasse Family Health Center along Garden Street and the Methodist's Carver Family Clinic, along John H. Gwynn Blvd., had both become Heartland sites on Peoria's South Side.

Heartland expanded again in 2007 when it built a clinic out of an old pharmacy in a shopping plaza along Wisconsin Avenue in the East Bluff.

Heartland CEO Farrell Davies sees Heartland's latest addition — St. Francis' Sisters' Community Health Care Center in the old Allied Agencies Building at 320 E. Armstrong — as coming full circle, back to its origins as a free clinic founded by a St. Francis doctor, David Gorenz, and his wife, and eventually anchored by St. Francis' Mother Frances Krasse Family Health Center.

But the merger is also recognition that community health clinics face the same challenges of cutting costs and improving overall patient health forcing the wave of mergers and affiliations among much larger healthcare systems, according to Davies.

"Nationally, how we perceive healthcare, its focus and how it's funded is evolving," Davies said. "You're going to see a lot of different partnerships and alliances as everyone tries to figure out the best way to provide care."

On Thursday, the last day Sisters' clinic actually operated as Sisters' clinic, the clinic was busy. (It was closed Friday to prepare for the changeover.)

Antoinette Johnson, who usually accompanies her mother, Linda Eckwood, on appointments, had not heard that the clinic was merging into Heartland. Neither had other patients in the waiting room.

But, like Johnson, they were familiar with Heartland. Johnson had been a Heartland patient before she found a job that offered health coverage benefits about two years ago.

As far as healthcare goes, Heartland's only goal is to improve services to patients, Davies said. But there could be more changes. Asked if Heartland had considered a merger with the Methodist Family Practice Clinic on the campus of the University of Illinois College of Medicine at Peoria, she laughed.

"We've told them we'd be open to that."

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Pam Adams can be reached at 686-3245 or padams@pjstar.com. Follow her on Twitter @padamspam.